Program

Family Check-Up (FCU)

Family Check-Up (FCU) is a family-centered intervention designed to motivate mothers to promote more consistent child management practices. The program was designed for parents of young children and has been adapted for parents of adolescents. An efficacy study, with 120 toddler-age boys at risk for conduct problems, found significant reductions in disruptive behavior, and greater maternal involvement. An evaluation of the school-based version of the program found significant increases in self-regulation among middle school students, which in turn reduced the risk for increased antisocial behaviors, involvement with deviant peers, and alcohol, tobacco, and marijuana use over time.

DESCRIPTION OF PROGRAM

Target population: Parents of children and adolescents who demonstrate problem behaviors.

Early Childhood Intervention

The Family Check-Up (FCU) for young children is a home-based intervention designed for mothers with children at risk for future problem behaviors, and is administered by parent consultants who are trained for 2.5 to 3 months prior to intervention delivery. The intervention is comprised of three sessions, which include an initial meeting and assessment, a “get to know you” meeting with a parent consultant, and a final meeting session to deliver feedback. During the initial meeting, families participate in a 2.5-hour home visit, where they are video-taped engaging in a variety of tasks, including free play, a clean-up task, a gratification-delaying task, three teaching tasks, a second clean-up task, the presentation of two toys that challenge inhibition, and a meal preparation task. Mothers are rated on their parental involvement and supervision, and also asked to complete a series of questionnaires assessing the child’s level of depression and inhibition and the child’s behavior problems. In the second session, a parent consultant asks parents about their concerns and family issues related to child well-being. The third meeting involves a feedback session, where the parent consultant discusses their observations and ratings with the parents. Parents are also offered a maximum of six follow-up sessions.

Adolescent Intervention

The Family Check-Up (FCU) for adolescents is a school-based intervention that takes a tiered approach. A family resource center, staffed by a trained parent consultant, is available to all parents in the school, and is intended to increase family-school connections. In addition, all students are screened for risk factors related to emotional, behavioral, or academic concerns. Following a three-session intervention similar to that of the early childhood intervention (e.g., initial meeting, assess challenges and goals, feedback), the parent consultant offers individualized supports to families of students who are identified through the screening process. Toward the end of the feedback session, families are presented with a list of intervention options that are relevant to their specific needs. The parent consultant encourages families to select the interventions that they think will be most helpful to them, and the consultant may either provide those additional services or help the family to access school- or community-based resources. In contrast to the early childhood intervention, sessions are conducted at school, rather than in the home.

Evaluated population: 120 mother-son dyads participated in the intervention. On average, mothers were 27 years of age, and their sons were 24 months. Of the total sample, 48.3 % were African American, 40% were Caucasian, and 11.7% were biracial.

Approach: Families were recruited at WIC program sites, and were selected to participate in the FCU intervention based on their level of socioeconomic risk, family risk (e.g., maternal depression or substance abuse) and child risk (e.g., conduct problems). If the identified risks were only socioeconomic or family-specific, only families whose children were also identified to be at risk for conduct problems were eligible to participate. Those who met the criteria and agreed to participate were randomly assigned to a treatment or control condition. Two post-intervention home visits, at 12 and 24 months following the initial meeting, were also conducted, when children were approximately three and four years of age, respectively. Families were given $125for participating in the initial three sessions, and an additional $125for participating in both follow-up sessions.

Results:Overall, significant decreases in disruptive behavior were found for boys in the treatment condition with low levels of inhibition and mothers with average levels of depression, and for boys in the treatment condition with average levels of inhibition and mothers with high levels of depression. Similarly, mothers in the treatment condition had significant increases in parental involvement, compared with those in the control condition. Caucasian mothers were found to have greater maternal involvement than African American and biracial mothers, when their sons were two years of age.

Evaluated population: A total of 731 children and their caregivers participated in the intervention. Children had a mean age of 30 months, and the sample was 49 percent female. The sample was 50 percent European American, 28 percent African American, 13 percent biracial, and 9 percent other races.

Approach: Same as study 1; however, this study focuses on parent’s positive behavior support and children’s school readiness competencies. Positive behavior support was measured with four indicators derived from at-home observations of parent-child interaction during semi-structured tasks. Families received $100 for participating in the age –two assessment, $120 for the age-three assessment, and $140 for the age-four assessment.

Results: Overall, the FCU was indirectly related, through its effects on parents’ increased positive behavior support, to improvements in school readiness in young, low-income children at risk for early conduct problems. Specifically, parents’ positive behavior support at age two promoted children’s self-regulation at age three, which in turn contributed positively to their language skills at age four.

Evaluated population: 593 sixth-grade students and their families, attending three middle schools in an urban area in the Pacific Northwest, were randomized to either the intervention group (n=386) or the control group (n=207). A total of 49 percent of the children were female; 36 percent were Caucasian, 18 percent Hispanic, 15 percent African American, 10 percent Asian or Pacific Islander, 2 percent Native American, and 19 percent were of mixed ethnicity.

Approach: The families of every sixth-grade student enrolled in each school were invited to participate in the three-year study; 82 percent agreed to do so. In the spring of each year, students were asked to complete a questionnaire assessing their self-regulation skills and how often they engage in certain high-risk behaviors (e.g., deviant behavior, use of illegal substances like tobacco, alcohol, marijuana). While the family resource center was available to all families, the parent consultant made particular efforts to engage with the families of students in the intervention group, who were identified as at risk for problem behaviors during the school-wide screening process. Parent consultants also offered the three-session FCU intervention (e.g., initial meeting, assessing challenges and goals, feedback) to any family in the intervention group that was interested, regardless of the risk profile of the student; approximately 42 percent of eligible families agreed to participate. Among families who participated in all three sessions, 78 percent engaged in follow-up services, most of which were designed to improve parents’ abilities to set limits, monitor their child’s behavior, communicate effectively, and problem-solve with their child. Intervention families received an average of 94.2 minutes of intervention services over the three-year study period.

Results: Overall, being in the intervention group was associated with improved self-regulation among adolescents in sixth and seventh grades. While students in both the intervention and control groups had increases in deviant behaviors over the course of middle school, improved self-regulation in seventh grade was associated with a smaller increase in antisocial behaviors; less time spent with deviant peers; and less use of cigarettes, alcohol, or marijuana.